Is there a doctor/nurse in the house?

Jan 28, 2011 | Self

[Brytani]

Medical question for you all.

Yesterday, out of my own stupidity, I ended up in the Emergency Room with chest pains, rapid heart rate, super high blood pressure, lightheadedness and low blood sugar. We thought I was having a heart attack and Thank the Lord it was not.

On Monday I had met with my GP and had asked him to take me off of one medication I've been on for about 6 months, and replace it with another. He was agreeable to this but did tell me I needed to taper off using the former medication and told me how to do it. Knowing I know better than my doctor (yea - lol) I just went cold turkey. My body let me know yesterday I'm not smarter than my doctor.

After multiple tests to figure out what was going on, the ER doctor came in to fill me in - my heart was fine, thankfully, very strong. This type of reaction can do serious harm (if not permanent end of life) to those with a weakened heart. Before leaving he told me he was going to give me something there so that I would feel better and a medication to take home, then directed me to return to the previous medication and go off it properly.

Here's the problem and question. The female nurse I had assigned to me had a bad attitude from the moment I got into the ER. When I was first wheeled into the room the bed was not made. Another guy made the bed and got me into it. The nurse came in and chastised me, wanting to know why I'd made the bed....huh?

After a bit a line was put into my left forearm, about 2 inches below the elbow, the line was closed and taped over. Above that BP cuff was placed along with the oxygen monitor. It took over 30 minutes (hubby timed it) to complete all of this, the longest being the line. After being stuck 4 times by one person, I asked for someone who knew what they were doing. My nurse called in another tech who took the line and on the second attempt got it into place.

After waiting a few hours and speaking to the doctor, the nurse came in to tell me she was giving me medications for nausea and something for pain.

This did not make sense to me, I was not nauseas and was not in pain. I asked her why those two medicines and was told "well fine, I'll just put down you refused them!".

Trying to hold my temper, I told her I was not refusing the meds, I was simply asking why those two without something to stop the reaction I was having for stopping medication too abruptly. At that point she said ohhh and he's giving you (another medicine) which cleared things up. In fact, if she had told me the three in the first place, I would not have had to ask any questions. But, I guess to this lady, asking a question is refusing them.

It's what happened next that I really need to find out about. The drugs were mixed with I assume saline and injected into the IV line. The first burned/pressure but nothing to bad. The second one went in and there was real pain which she dismissed as "it happens to everyone" when I sort-of gasped. The third has me angry, a bit concerned and wondering what to do.

As she was pushing through the third medication the pain was pretty intense, burning, ripping, high pressure feeling as she began to push the 3rd med through she simultaneously turned ON the blood pressure cuff right above the IV line. When that turned on and began applying pressure, I was literally watching a large bump grow on my inner arm to the size of a walnut. I expected it to pop open or push out the IV there was that much pressure and very intense pain.

When I was released from the ER and the line was removed, I had an almost rock hard, solid lump, where the line had been the size of a golf ball that was tender to the touch. I showed this to the nurse who said "oh, you have a hematoma" and walked away. Today, the lump is 3/4 the way down but my arm has a bruise almost 5 inches long, 2 inches wide and hurts from any touch/pressure.

1. Is it proper to turn on an BP cuff while pushing into an IV line medicine that close to the cuff?

2. Should I complain to the hospital administrators about not only her attitude (which we had planned on doing, there was much more than I wrote) and also my arm and the condition it is today? Also, in ER medicine, does the fact a patient wants to know the reasons why a medicine is being given considered a "refusal" by the patient?

3. Just in case, is there anything strange I should look for if this gets worse?

4. Before anyone asks, no I'm not suing. No ambulance chasers are in my future.

Thanks!

[cva66snipe]

Write a letter to the hospital Chief Of Staff & Director of Nursing. These two can do something about it. I've found it is effective as I did it instead of suing a hospital and a highly unprofessional and negligent attending ER physician. He refused to do warranted procedures like blood work and in this case did not do a PDR to see symptoms of an adverse medication reaction on a family member. The patient had Serotonin Syndrome which can be deadly real fast. The doctor I wrote to the C.O.S. about no longer practices at that hospital. The C.O.S. also knew I was right as he himself had treated the same patient in question before.

I worded the letter to the effect that if this ever happened to anyone else and we heard about it we would be witnesses for anyone wishing to sue. This tells them you aren't out for money but rather you intend for them to do something to correct what happened so it does not happen again. A very small percentage of nurses are there solely for the money. These type can become highly abusive and negligent. By informing both the C.O.S. and Director of Nursing of your treatment you prevent either from covering it up. Most important though you should tell your doctor what happened and question him about the lump.

I was admitted to the hospital last week overnite for observation and a stress test due to chest pains. The IV port goes on one arm the BP cup on the other. No one took my BP from the IV arm.

[DrC]

I wasn’t in any way implying that your “diagnosis” was wrong. Indeed, it explains many of the symptoms reported. I was simply providing the technical definition of a hematoma and saying that it was possible that the hematoma alone caused these same symptoms.

I don’t think it’s an either/or situation. Both medication leakage and blood leakage may well have occurred. It’s good that this is being reported.

[yefragetuwrabrumuy]

I agree, but my point was that when you complain, people usually bring up attitude first, which is a mistake, because it’s always an emotional “he said-she said” contest, which is hard to adjudicate. Again, because they have to figure out *after the fact*, if she *did* have a bad attitude, or you just *thought* that she had a bad attitude. In such cases, they rarely find wholly in your favor.

This is why you should *start* by talking about her objective mistakes, and you mentioned several. Talk about her attitude later, *after* you have established that it is far more important what she physically *did* than what she was *feeling* at the time.

Oddly enough, a lot of people are more interested in airing their grievances to somebody, anybody, than they are of getting real change. So this is a question that you need to ask yourself: do you want her to stop acting like this; or do you just want to complain to somebody?

[Allthegoodusernamesaregone]

Call me..

[Allthegoodusernamesaregone]

Sorry, the “call me” was for Bry :)

[Brytani]

Thanks for the offer but to be honest, I really hope any occasion for me to visit an ER will be few and far apart... :-)

[Brytani]

Thanks for the information and advice, it’s appreciated....

A letter is in the works right now, including pictures of my arm (the remaining “lump” is clearly visible). My husband called this morning to find out the name of the Director of Nursing, Supervisor of Nursing in the ER and others. Letters will go out, certified, Monday with phone calls placed.

I’ve spoken to my GP who wants me in his office Monday. Of the conditions he told me to watch out for is being overly sleepy, as in simply not being able to stay awake. I’m tired and can easily take a nap at anytime but I’m in control. No other emergency condition has developed so I should be good until Monday.

I’ve yet to hear from anyone from trained professionals (doctors and nurses) to EMT’s and other health care providers who say the BP cuff should be on the same arm as the IV line unless there is absolutely no other choice.

What professionals I’ve spoken to can not believe was the nurse manually turning on the BP cuff while pushing meds.

Thanks again

[Brytani]

Hey - We’re about to run up to the store and I’m going to lay down when we get back. Will you be home this evening, say around 7pm?

[Allthegoodusernamesaregone]

Yes. Round up all the info from the ER visit (meds you were given and everything else) and let doc handle it ;)

XXOO

[Brytani]

You have got to be kidding me, right? From the get-go I was very clear, no lawsuits (ambulance chasers) and I said this from my first post.

2. Should I complain to the hospital administrators about not only her attitude (which we had planned on doing, there was much more than I wrote) and also my arm and the condition it is today? Also, in ER medicine, does the fact a patient wants to know the reasons why a medicine is being given considered a "refusal" by the patient?

Which was followed up by me saying, multiple times, that this nurse does not need to be working with patients. Obviously I simply want to rant to someone so that she will never be in the ER if and when I happen to go in there again.

Since I have laid out what we have done, what we intend to do and have asked questions specific to these plans to help the hospital administration take appropriate measures against the nurse. You may wish to take the time to read the thread before determining my motivations.

[Judith Anne]

I hate that this happened to you. If that nurse worked for me, she’d be answering to the state licensing board the next day. I agree with the person who said go to the hospital ADMINISTRATOR in person, with your husband, asap. Nothing has an impact quite like that.

Demand an apology. The treatment was horribly wrong, and not excusable. IV and BP are NEVER on the same arm, unless there are IVs in both arms (not too common).

The nurse’s attitude matters far less than her complete incompetence. But it DOES matter, as well.

[Judith Anne]

PS, you’ve gotten some really excellent responses on this thread. You never know, you may have helped someone else just by bringing this up.

[Brytani]

Yes I have and one of the reasons I bought this up. Aside from knowing how many Freepers work in the medical field, I also know threads on FR is picked up by more than other Freepers.

I’m calling it a night - THANKS YOU all for the advice and recommendations. I’ll update the thread if and when I hear back from the hospital administration.

[60Gunner]

No sweat here, Doc. I can always stand to learn more- it's part of the critical thinking process.

Cheers and good health to you!

[60Gunner]

Amen. Here's hoping we never meet anywhere but a coffee shop.

/Gunner

[SunnyUsa]

Just reading your thread - I'm a nurse and I'm embarressed about the unprofessional way you were treated.

It was your nurses job to let you know the medications you were about to get - especially IVP (IV push meds). Whenever a patient questions their medications I take the time to explain them --- we also have medication info printouts to give to the patient if they want them.

The fact that it took several "sticks" to get your IV line unfortunately happens. You may have been a difficult stick-as a rule I won't try more than 2 times - maybe 3 if I think I definitely can get it.

Otherwise nurses work together to help each other out if one person can't get the IV in.

The fact that your BP cuff was left on your IV site arm is also not the best practice - especially when your medications were being given. Medications can burn going in unfortunately

Unforunately some nurses and doctors need to be "reminded" what their job is and how to treat patients profeessionally.

A note to the administration will certainly get everyone's attention. I would copy the Director of Nursing, The Director Education and Customer Service as well as the ER department manager for starters. I would outline how you were treated and what was said to you. IF I was you - as a patient - I certainly wouldn't have felt "safe" with the care.

Your letter will get noticed.